​We can assist you from initial enquiry throughout the assessment process and also through to dispute if required.

We can provide an on-site or remote clinical assessment of health and care records and complete a Decision Support Tool Document, which is the same document used by the NHS. This will follow the Continuing Healthcare Criteria and evidence an independent recommendation of eligibility where appropriate. We are also skilled in representing clients at Multi-Disciplinary Team Meetings, Continuing Healthcare panels and review or dispute meetings. We can provide support to take your case to the Health Service Ombudsman if required.

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What is Continuing Healthcare?

Continuing Healthcare is a package of funding provided solely by the NHS to people who are considered to have a Primary Health Need.

Disputes

Local Review Panel (LRM)

A meeting will be arranged either at the are home, or at the local offices of the Continuing Healthcare Team. This meeting is an opportunity to have another look at the decision made, and to provide additional evidence to support eligibility. There may also be a second meeting held with more senior staff, if the family are unhappy with the outcome of the first meeting.

Independent Review Panel (IRP)

If you cannot reach a decision at Local Resolution, you can proceed to IRP where your case is reviewed by NHS England. A panel will be convened with an independent chair and representatives from Health and Social Care from outside of your area. The independent panel will review your case and you will again have the opportunity to discuss the areas of your assessment that you wish to dispute. This is a very important meeting, and it is highly advisable to have someone experienced in Continuing Healthcare such as ourselves to represent you. Of note, on most occasions legal representatives (solicitors etc) are not effective at these meetings as this is a clinical process and not a legal one).

Parliamentary Health Service Ombudsman (PHSO)

Once you have exhausted all of the NHS complaints process, if you are still unhappy with the way your case has been dealt with or the outcome of your case, you can forward all of the details to the ombudsman who will assess your complaint in line with process and procedures. The ombudsman cannot advise on the clinical decision made but they can act if your assessment has been handled without due care and attention to process.

A Primary Health Need is determined by the Nature, Complexity, Intensity and Unpredictability of a person’s health needs and the level of support the person requires, either within their own home or a nursing home.

Continuing Healthcare is not for everyone and although someone may be considered very frail or even end of life, their needs may not be considered a Primary Health Need therefore not everyone is entitled to receive CHC.

Continuing Healthcare is not permanent! Although someone may be granted Continuing Healthcare, this is regularly reviewed and if the persons needs change and there is what may be considered an improvement, Continuing Healthcare can and will be withdrawn.

The decision is not final! If an application for Continuing Healthcare is declined, this will be regularly reviewed. If the persons needs change, a reassessment can be requested at any time. A negative decision can also be disputed and we can assist with this.

Reviews:

Continuing Healthcare is reviewed periodically or if there is a change of need. If a person’s needs change within the time between reviews, a review can be requested.